Author and clinical psychologist David Richo (n.d.) states
“[o]ur wounds are often the openings into the best and most beautiful part of
us” (para. 1). However, “…to better understand, predict, and alleviate
‘intellectual, emotional, biological, psychological, social, and behavioral
aspects of human functioning’ clinical psychology focuses on the health and
dysfunction of a person’s being” (Plante, 2011, p. 5). Thus, clinical
psychology attempts to use the scientific method to identify and treat
emotional and behavioral problems. In an examination of clinical psychology it
is necessary to review its history and evolving nature, the role research and
statistics plays, and the differences between clinical psychology to other
mental health professions.
The History and Evolving
Nature of Clinical Psychology
Long before psychology was established as a scientific field,
dedicated to alleviating human suffering in the emotional, behavioral, and
physical realms, such influences were thought to be of a supernatural influence
(Plante, 2011). Not unlike some modern approaches, the ancient Greeks believed
holistic rituals (e.g., prayer, foods, bathing, etc.) could stimulate healing
and bring the body back into balance (Plante, 2011). Hippocrates believed that
a person’s environmental conditions affect the etiology of his or her illness,
thus one’s biological, psychological, and social factors all contribute to
physiological well-being (Plante, 2011). Furthermore, Hippocrates and his
followers, Plato, Socrates, Aristotle, and Galen helped to establish the holistic
perspective that is essentially in use today.
As disease and war spread during the Middle Ages, fear
gripped the world turning treatment of medical and mental illness toward the
spiritual and supernatural realm of exorcism and persecution, where some
“…150,000 were executed in the name of religion…” (Kemp, 1990 as restated by
Plante, 2011, p. 35). However, there are some (e.g., Aquinas, Paracelsus, and Vives)
who thought otherwise, helping to shift belief away from the supernatural back
toward the physical and the astrological but sadly this did not improve the inhumane
treatment of the mentally ill of that time (Plante, 2011). After the dark ages,
the Renaissance ushered in a time of “revival or rebirth” for empirical efforts
giving momentum to new philosophies about psychology (Renaissance, n.d., para.
1). What Goodwin (2008) called an “era of revolutionary developments in
science” (p. 32). A few of the great minds from this era are Galileo, Newton,
and most notably, Rene’ Descartes, mathematician, anatomist, and philosopher.
He was the first to suggest a Cognitive Perspective of psychology; “arguing for
a clear separation between mind (or ‘soul’) and body” (Goodwin, 2008, p. 34).
Unlike Descartes, John Locke, philosopher, physician, and medical researcher
brought about a more Humanistic Perspective. He suggests that each person is
born as a tabula rasa, or blank
slate, thus developing through experience; including thought and reflection
(Goodwin, 2008).
The Nineteenth Century saw a profound movement toward more humane
and moral treatment of the mentally ill (Plante, 2011). French physician
Phillippe Pinel began the “moral therapy” movement, encouraging improved living
conditions and treatment through nurturing and interpersonal relationships
(Plante, 2011). Dorothea Dix, school teacher and head nurse during the Civil
War, petitioned for improved treatment and conditions for the mentally ill within
the United States; after 40 years “New Jersey became the first state to build a
hospital for the mentally ill in 1848” (Plante, 2011, p. 37). As the formal science
of psychology was forming, William Wundt, founder of the Structuralism Perspective,
established its first laboratory in 1879. At this same time William James was
establishing the first “psychology laboratory at Harvard University” in the
U.S. (Plante, 2011, p. 38). However, James is credited with founding the Functionalist
Perspective; emphasizing the adaptiveness of both mental and behavioral
processes.
Perhaps one of the most controversial theorists’ of the
Nineteenth Century is Sigmund Freud. However, as “the ancient Greeks believed, Freud
reawakened… a more holistic view… of health, illness, and abnormal behavior”
(Plante, 2011, p. 46). Freud’s Psychoanalytic Perspective opened the door for
future theorists’ and perspectives. Although, the term “Psychology” was first
coined by Lightner Witmer, he was also the first to “develop [and use] a
specific [psychological] treatment program” (Plante, 2011, pp. 38-39). Witmer
is further credited for opening the first psychology clinic, which is still in
operation today.
Intelligence testing is a major development in the
psychological realm; used in almost all perspectives. Initially developed by
Alfred Binet and colleague Theodore Simon, the Binet-Simon scale was issued in
1908; although it was believed to lack
the necessary “comprehensive and objective index of intellectual functioning…
for use beyond the classroom” (Plante, 2011, p. 40). The revised Stanford-Binet
intelligence test was profoundly popular and during both World Wars the
military turned to psychology and these tests to evaluate its troops (Plante,
2011). Shortly thereafter, Government programs (VA & NIMH) were designed to
help train thousands of students in the mental health field to accommodate the influx
of mental health patients created by both wars. In addition APA standards and
guidelines for graduate and internship training are continually changing to
include new comprehensive research, treatment, and assessment updates (Plante,
2011). With new models of clinical training disseminated to licensed,
practicing clinicians periodically at “conference events” (e.g., Boulder, 1949;
Miami, 1958; Chicago, 1965; etc…).
As stated by Plante (2011), “Just as this mind-body
integration has developed, the practice and training of clinical psychologists
have mirrored landmark scientific changes in this evolving field of study” (p.
31). Thus, it is just as important for the evolution of clinical psychology
that the Diagnostic and Statistical Manual
(DSM) and the Ethical Standards of care, that were developed in the 1950s to
provide mental health practitioners guidelines for enabling better care, continue
to evolve as the fields of study evolve.
The Role of Research
and Statistics in Clinical Psychology
Founded on the backbone of research, clinical psychology
uses questionnaires, laboratory experiments, and archival data studies
“…to better understand human behavior… develop psychological assessment techniques and treatment strategies that are reliable, valid and effective. [Therefore,]… The general goal of research in clinical psychology is to acquire knowledge about human behavior and to use this knowledge to help improve the lives of individuals, families, and groups” (Plante, 2011, p. 74).
Thus, when a person realizes that he or she is in distress
and seeks the service of a clinical psychologist the research then relies
largely on the validity of personal interviews, individual studies, and in a
clinicians research he or she should be allowing the user to direct the flow of
questions as to not bias the perspective (McCourt, 2011). After all, basic and
applied research provides the basis and direction that allows practitioners to
use his or her techniques with confidence in a practical setting.
The Differences Between
Clinical Psychology and Other Mental Health Professions
When practitioners use his or her psychological techniques
it is always with the consideration of the profession for which he or she is
working. For example the differences between clinical psychology and other
mental health professions, such as social work, psychiatry, and school
psychology include training, focus, and location.
Clinical Psychology requires either a Doctorate of
Philosophy (PhD) or a Doctorate of Psychology (PsyD). However, unlike the
medical doctorate training, the clinical psychologist spends his or her time
focusing on mental health research, assessment, and treatment related issues.
Clinical Psychologists are also found in a variety of vocations; teaching,
consulting, administration, private practice, education, hospitals, and more.
Social workers can become licensed clinical case workers or
obtain a bachelor degree in social science and then a master’s in social work.
However, training focuses less on research and more on administration. “Historically,
social workers focus on patient case management, patient advocacy, and a
liaison to optimal social service agencies and benefits” (Plante, 2011, p. 25).
Social workers are employed by schools, hospitals, social service agencies,
private practice, and more.
Psychiatry is a field that requires an extensive medical
degree (MD) and a complete residency spending many years in school, with 40%
working private practice, according to the APA (2010) as restated by Plante
(2011). Although, Psychiatrists have the ability to diagnose, treat, and
prescribe medications for a variety of medical and mental health issues.
A school psychologist will typically have a master’s degree
and work in elementary, secondary, or some type of special education program.
However, some do choose to persue his or her PhD for research opportunities
(Plante, 2011).
Conclusion
From the profound beginnings to the multifaceted approaches
that are available today, clinical psychologies history has evolved
considerably. Understand that research designed around mental well-being is the
most important aspect of clinical psychology; it allows psychologists to remain
abreast of the current theories, assessments, and treatments. However, when a
potential student understands the different disciplines, he or she is able to
make appropriate decisions on a career, thus making both future patients and practitioner
happy and fulfilled.
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